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Hawaii law restricts sale of short-term plans

Hawaii enacted HB1520 (Act 192) in July 2018. The legislation prohibits the sale or renewal of a short-term plan to anyone who was eligible to purchase a plan in the exchange during the previous calendar year, either during open enrollment or during a special enrollment period.

Short-term plans limited to 90 days

The legislation also limits short-term plans to no more than 90 days in duration, and took effect immediately, in July 2018.

The legislation prohibits renewal and/or re-enrollment for anyone who was eligible to purchase a plan in the exchange during the previous year, and defines “renew or reenroll” as providing coverage (under a new plan or the renewal of an existing plan) to anyone who has had coverage under a short-term plan within the previous calendar year. So a person was eligible to purchase a plan in the exchange cannot buy a short-term plan for the first time, and also cannot renew a short-term plan or purchase a subsequent short-term plan if they already have one.

Because HB1520 bans the sale or renewal of short-term plans to anyone who was eligible to purchase an ACA-compliant plan in the exchange during the previous calendar year, it essentially eliminates the market for short-term plans in Hawaii — because virtually everyone is eligible to purchase coverage in the exchange in any given calendar year.

The only people who aren’t eligible to purchase a plan in the exchange are undocumented immigrants, incarcerated individuals, and people who are eligible for premium-free Medicare Part A.

Until October 2, 2018, federal regulations limited short-term plans to three months in duration, and prohibited renewal. The Trump Administration has relaxed those rules, but only in states that allow it. Since Hawaii passed legislation in 2018 to limit short-term plans to 90 days (and to sharply limit eligibility), the new federal rules (allowing for longer short-term plans) do not apply in Hawaii.

And although short-term plans used to be available for sale in Hawaii, that is no longer the case. Insurers that previously offered short-term plans in the state have stopped doing so, likely because hardly anyone was eligible to purchase the plans.

Insurers have stopped offering short-term health insurance in Hawaii

As of early October 2018, National General was still offering short-term plans in Hawaii. But by late October, there were no longer any short-term plans for sale in the state. Several insurers are offering fixed indemnity plans, but those are not the same thing as short-term health insurance.